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To lower or not to lower? Making sense of the latest research on intensive glycaemic control and cardiovascular outcomes
1 School of Nursing, McMaster University, Hamilton, Ontario, Canada
2 McMaster University Medical Centre, Hamilton, Ontario, Canada
| The first 150 words of the full text of this article appear below. |
Diabetes is an extremely burdensome and costly chronic disease. It affects an estimated 4–6% of the world’s population, and its prevalence continues to rise.1 2 Diabetes is a major cause of blindness, end stage renal disease, and cardiovascular complications, all of which are preventable.3 4 Clinical practice guidelines for the management of diabetes emphasise the importance of optimal glycaemic control. Specifically, some clinical practice guidelines have suggested targeting a glycated haemoglobin (Hb) A1c concentration 
7%, or 6% for those able to safely achieve it.5
With the recent publication of 3 notable trials, a great deal of debate and confusion has been created about the cardiovascular effects of lowering glucose to near-normal concentrations in people with type 2 diabetes. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the Action in Diabetes and Vascular Disease: Preterax and Damicron Modified Release Controlled Evaluation (ADVANCE) trial, and the 10-year follow-up of the UK Prospective
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This article has been cited by other articles:
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(2009). To lower or not to lower? Making sense of the latest research on intensive glycaemic control and cardiovascular outcomes. Evid. Based Nurs.
12: 38-38
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